| NPI | 1255590816 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant | 
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist | 
| Enumeration Date | 2008-06-08 | 
| Last Update Date | 2008-06-08 |